Ticket for Outdoor Patient
| Ward No. 27 | U-PHC No. | Registration No. 00737 | Date 15/01/2020 |
| Token No | SM/19-20/3512 30/03/2020 | Serial | 005 |
| Patient Name | Mrs. PRATIMA DAS | Contact No | 8620979821 |
| Address | 65/4 CHAKLAPARA PRABASHNAGAR SERAMPORE 712249 | Age | 55 YRS Female |
| Token For | Visit Doctor,Medicine, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||